The electronic health record as a teaching and learning tool in residency training: A scoping review

Background While the electronic health records (EHR) is a critical tool for clinical care in academic medical centers, there is a gap in the literature regarding utilization of EHRs for teaching and learning in residency training, outside of descriptions on EHR training or use for quality improvement projects. The research question for this scoping review is: How is the EHR purposefully used in educational interventions for teaching and learning in graduate medical education? Methods We searched all publications in PubMed, SCOPUS, CINAHL, ERIC, Cochrane and MedEdPORTAL databases from 2010 to 2022 that met our search criteria and MeSH terms. Using Arksey and O'Malley's framework, the abstracts were reviewed by three team members, and the full text was reviewed by all authors using a standardized data extraction sheet. Results Of the 2431 records, 19 met inclusion criteria and were reviewed in full. All studies were set in North America, 79% at teaching hospitals, and 42% in Internal Medicine programs. The EHR was used purposefully to improve learning in sepsis, diabetes, asthma, critical care, post- and peri-operative care, and it was used to provide feedback about clinical performance, test utilization, costs of care, and errors. The educational interventions included simulation, direct feedback using EHR data, and workshops with pre-post knowledge and skills testing. Conclusions This scoping review identifies how the EHR is being used as a teaching and learning tool for trainees. There is a need for more purposeful use of the EHR in designing educational interventions for residents.